Jason Payne-James, Louise Parapanos, Tim Bosworth, Saverio Virdone, Jes Fry, Jacqueline Lake
{"title":"英国诺福克和诺威奇大学医院在引入法医服务前后向皇家验尸官发出通知的性质和结果的变化:2018 年与 2022 年。","authors":"Jason Payne-James, Louise Parapanos, Tim Bosworth, Saverio Virdone, Jes Fry, Jacqueline Lake","doi":"10.1177/00258024241260573","DOIUrl":null,"url":null,"abstract":"<p><p>A medical examiner (ME) system was introduced to England and Wales in 2019 intended to ensure appropriate notification of cases to HM Coroner (HMC). The aim of the study is to determine and compare: (a) the nature of notifications to HMC for Norfolk from the Norfolk and Norwich University Hospital (NNUH) in 2018 compared with 2022; (b) to determine the outcome of those notifications and (c) to establish patterns of change in the number and nature of such notifications. HMC and ME datasets were interrogated to determine differences between notifications to HMC and outcomes in 2018 compared with 2022. From deaths at NNUH (2018 - n = 2605; 2022 - n = 2969), there were significantly fewer HMC notifications in 2022 compared with 2018 (25.3% vs. 17.6%). A decrease in notifications was noted for persons undergoing any 'treatment or procedure of a medical or similar nature' (24.0% vs. 16.2%) <i>p</i> < 0.0014. An increase in notifications was noted for neglect, including self-neglect (3.3% vs. 12.2%) <i>p</i> < 0.001. Of the coronial outcomes, there were significant increases in the numbers of post-mortem (PM) examinations (29.3% vs. 35.5%) <i>p</i> = 0.0276 and inquests (26.0% vs. 31.4%) <i>p</i> = 0.0485). There was a significant decrease in no further action by HMC (5.7 vs. 2.3) <i>p</i> = 0.0485. The study shows that the introduction of the medical examiner service has resulted in significant change in the nature of HMC notification categories. The notifications appear to be more appropriate, with an increased proportion of inquests and PM examinations and with a reduction in 100 A or 'no further action' outcomes.</p>","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Changes in the nature and outcome of notifications to HM Coroner from the Norfolk and Norwich University Hospital, UK, before and after the introduction of a medical examiner service: 2018 versus 2022.\",\"authors\":\"Jason Payne-James, Louise Parapanos, Tim Bosworth, Saverio Virdone, Jes Fry, Jacqueline Lake\",\"doi\":\"10.1177/00258024241260573\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>A medical examiner (ME) system was introduced to England and Wales in 2019 intended to ensure appropriate notification of cases to HM Coroner (HMC). The aim of the study is to determine and compare: (a) the nature of notifications to HMC for Norfolk from the Norfolk and Norwich University Hospital (NNUH) in 2018 compared with 2022; (b) to determine the outcome of those notifications and (c) to establish patterns of change in the number and nature of such notifications. HMC and ME datasets were interrogated to determine differences between notifications to HMC and outcomes in 2018 compared with 2022. From deaths at NNUH (2018 - n = 2605; 2022 - n = 2969), there were significantly fewer HMC notifications in 2022 compared with 2018 (25.3% vs. 17.6%). A decrease in notifications was noted for persons undergoing any 'treatment or procedure of a medical or similar nature' (24.0% vs. 16.2%) <i>p</i> < 0.0014. An increase in notifications was noted for neglect, including self-neglect (3.3% vs. 12.2%) <i>p</i> < 0.001. Of the coronial outcomes, there were significant increases in the numbers of post-mortem (PM) examinations (29.3% vs. 35.5%) <i>p</i> = 0.0276 and inquests (26.0% vs. 31.4%) <i>p</i> = 0.0485). There was a significant decrease in no further action by HMC (5.7 vs. 2.3) <i>p</i> = 0.0485. The study shows that the introduction of the medical examiner service has resulted in significant change in the nature of HMC notification categories. The notifications appear to be more appropriate, with an increased proportion of inquests and PM examinations and with a reduction in 100 A or 'no further action' outcomes.</p>\",\"PeriodicalId\":18484,\"journal\":{\"name\":\"Medicine, Science and the Law\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicine, Science and the Law\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00258024241260573\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"LAW\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicine, Science and the Law","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00258024241260573","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"LAW","Score":null,"Total":0}
Changes in the nature and outcome of notifications to HM Coroner from the Norfolk and Norwich University Hospital, UK, before and after the introduction of a medical examiner service: 2018 versus 2022.
A medical examiner (ME) system was introduced to England and Wales in 2019 intended to ensure appropriate notification of cases to HM Coroner (HMC). The aim of the study is to determine and compare: (a) the nature of notifications to HMC for Norfolk from the Norfolk and Norwich University Hospital (NNUH) in 2018 compared with 2022; (b) to determine the outcome of those notifications and (c) to establish patterns of change in the number and nature of such notifications. HMC and ME datasets were interrogated to determine differences between notifications to HMC and outcomes in 2018 compared with 2022. From deaths at NNUH (2018 - n = 2605; 2022 - n = 2969), there were significantly fewer HMC notifications in 2022 compared with 2018 (25.3% vs. 17.6%). A decrease in notifications was noted for persons undergoing any 'treatment or procedure of a medical or similar nature' (24.0% vs. 16.2%) p < 0.0014. An increase in notifications was noted for neglect, including self-neglect (3.3% vs. 12.2%) p < 0.001. Of the coronial outcomes, there were significant increases in the numbers of post-mortem (PM) examinations (29.3% vs. 35.5%) p = 0.0276 and inquests (26.0% vs. 31.4%) p = 0.0485). There was a significant decrease in no further action by HMC (5.7 vs. 2.3) p = 0.0485. The study shows that the introduction of the medical examiner service has resulted in significant change in the nature of HMC notification categories. The notifications appear to be more appropriate, with an increased proportion of inquests and PM examinations and with a reduction in 100 A or 'no further action' outcomes.
期刊介绍:
Medicine, Science and the Law is the official journal of the British Academy for Forensic Sciences (BAFS). It is a peer reviewed journal dedicated to advancing the knowledge of forensic science and medicine. The journal aims to inform its readers from a broad perspective and demonstrate the interrelated nature and scope of the forensic disciplines. Through a variety of authoritative research articles submitted from across the globe, it covers a range of topical medico-legal issues. The journal keeps its readers informed of developments and trends through reporting, discussing and debating current issues of importance in forensic practice.